To shunt or not to shunt a pulmonary adenomatoid cystic malformation after 33 weeks of gestation: A case report

Rodrigo Ruano, Paula Beatriz Tavares Fettback, Vinicius Lima Ribeiro, Marcus Marques Silva, João Gilberto Maksoud, Marcelo Zugailo

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Context: Macrocystic adenomatoid malformation of the lung can cause severe mediastinal shift, hydrops and polyhydramnios, thereby increasing the risk of perinatal deaths. After 33 weeks of gestation, repeated puncturing of the cyst is recommended. We present a case in which a cyst-amniotic shunt was placed instead of performing this procedure. Case Report: A cyst-amniotic shunt was placed at 33 weeks of gestation because of a large macrocystic adenomatoid malformation of the lung associated with severe mediastinal shift and polyhydramnios. Although it was confirmed that the catheter was in the correct place, the cyst increased in size again two weeks later, associated with repetition of polyhydramnios. It was postulated that the catheter was blocked, and we chose to place another catheter instead of performing repeated punctures. The cystic volume, polyhydramnios and mediastinal shift regressed progressively. At 38.5 weeks, a 3,310 g male infant was delivered without presenting any respiratory distress. The infant underwent thoracotomy on the 15th day of life. Thus, in the present study, we discuss the possibility of placing a cyst-amniotic shunt instead of performing repeated cystic punctures, even at a gestational age close to full term.

Original languageEnglish (US)
Pages (from-to)239-241
Number of pages3
JournalSao Paulo Medical Journal
Issue number4
StatePublished - 2008


  • Abnormalities
  • Cystic adenomatoid malformation of lung congenital
  • Fetal therapy
  • Prenatal diagnosis
  • Ultrasonography

ASJC Scopus subject areas

  • General Medicine


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